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Cancer treatment in the United States

The following blog “The Cost of Cancer” is almost entirely based on a 60 Minute special produced by CBS and aired on October 5, 2014. Lesley Stahl was the correspondent on this CBS special and Richard Bonin was the producer. The person being interviewed was Dr. Leonard Saltz of the Memorial Sloan Kettering Institute.

Cancer touches nearly every family in this country and about one American in three will be diagnosed with this in their lives. The anxiety caused by a cancer diagnosis is added to when families find out the astronomical cost of medications to keep them alive. The catastrophic costs of medical care with a diagnosis such as this are one of the leading causes of personal bankruptcy in the United States.

Dr. Saltz says that the general cost for a new drug is over $100,000 per year and that the first couple of drugs used in treatment could cost over a quarter million dollars per year.

Dr. Saltz's battle against the cost of cancer drugs started in 2012 when the FDA approved Zaltrap for treating advanced colon cancer. Saltz compared the clinical trial results of Zaltrap to those of another drug already on the market, Avastin. Neither drug had a statistical advantage over the other. He says both target the same patient population, work essentially in the same way. And, when given as part of chemotherapy, deliver the identical result: extending median survival by 1.4 months, or 42 days.

Then Saltz, as head of the hospital's pharmacy committee, discovered it would cost: roughly $11,000 per month for Zaltrap, more than twice that of Avastin. Because in the final analysis the price tag for an extra 42 days of life would be $60,000, the medication, Zaltrap, was not approved because of price. What that would mean to a patient on Medicare would be an extra $2,000 per month.

The exorbitant prices of cancer treatments are likely because according to one study, a large percentage of the oncologist’s pay is from what they make on the medications by buying from big pharma at wholesale prices and then selling at the astounding markups allowed in selling for retail. Of course this is all legitimate isn’t it?

We all like to think of our caregivers as doing the best for us without compromising our care at the least expensive means of doing so. But should the choice of drugs used be up to caregivers? Especially should that choice be left up to caregivers when what they choose is going to influence their paychecks?

Why does our FDA approve new medications which are essentially unchanged from previous medications performing the same tasks? Is it worth the cost to society to spend several hundred million dollars to bring a new drug to market which extends life by a couple weeks or months to the select few needing that particular medication? That is probably not worth it even to the individual whose life is being extended.

Another thing to remember when looking at the excessive price of medications is that large pharmaceutical companies can charge whatever they want to charge for medications. Due to laws passed in 2003, the government is not allowed to negotiate for a better price. A great law for our government to pass, but for the benefit for whom? Certainly not for the American citizen!

For more on this interview with Lesly Stahl, visit

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